Provider Demographics
NPI:1225252315
Name:MYERS, KAREN LENORE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LENORE
Last Name:MYERS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:LENORE
Other - Last Name:EBERSPACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:6315 S 176TH STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-3032
Mailing Address - Country:US
Mailing Address - Phone:402-896-5982
Mailing Address - Fax:402-932-5123
Practice Address - Street 1:6315 S 176TH STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-3032
Practice Address - Country:US
Practice Address - Phone:402-896-5982
Practice Address - Fax:402-932-5123
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE333225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39582OtherBCBS